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NCLEX National Council Licensure Examination(NCLEX-RN) Sample Questions (Q388-Q393):

NEW QUESTION # 388
A 38-year-old female client with a history of chronic schizophrenia, paranoid type, is currently an outpatient at the local mental health and mental retardation clinic. The client comes in once a week for medication evaluation and/or refills. She self-administers haloperidol 5 mg twice a day and benztropine 1 mg once a day.
During a recent clinic visit, she says to the nurse, "I can't stay still at night. I toss and turn and can't fall asleep." The nurse suspects that she may be experiencing:

• A. Opisthotonos
• B. Dystonia
• C. Akinesia
• D. Akathisia

Answer: D

Explanation:
Explanation
(A) Akathisia, or motor restlessness, is a reversible EPS frequently associated with the administration of antipsychotic drugs such as haloperidol. (B) Akinesia, or muscular or motor retardation, is an example of reversible EPS frequently associated with the administration of major tranquilizers such as haloperidol. (C) Acute dystonic reactions, bizarre and severe muscle contractions usually of the tongue, face, neck or extraocular muscles, are examples of EPS. (D) Opisthotonos, a severe type of whole-body dystonic reaction in which the head and heels are bent backward while the body is bowed forward, is an example of EPS.

NEW QUESTION # 389
A client is a victim of domestic violence. She is now receiving assistance at a shelter for battered women. She tells the nurse about the cycle of violence that she has been experiencing in her relationship with her husband of 5 years. In the "tension-building phase," the nurse might expect the client to describe which of the following?

• A. A period of tenderness between the couple
• B. Acute battering of the client, characterized by his volatile discharge of tension
• C. Minor battering incidents, such as the throwing of food or dishes at her
• D. Promises of gifts that her husband made to her

Answer: C

Explanation:
Explanation
(A) This description is characteristic of the "honeymoon" or "respite" phase. (B) This description is characteristic of the "battering" phase. (C) This description is characteristic of the "tension- building" phase prior to the volatile discharge of tension found in the battering phase. (D) This description is characteristic of the "honeymoon" or "respite" phase.

NEW QUESTION # 390
Nursing care of the infant prior to surgical closure of a meningomyelocele would include:

• A. Cover sac with saline-soaked sterile dressing
• B. Do not apply dressing; keep sac open to air
• C. Cover sac with dry sterile dressing
• D. Aspirate any fluid from sac

Answer: A

Explanation:
Explanation
(A) A dry, sterile dressing would adhere to the sac, causing tissue damage. (B) A saline-soaked sterile dressing protects the sac from contamination by air and prevents drying. (C) A sac open to air causes drying and potential for contamination. (D) This intervention is not an independent nursing action.

NEW QUESTION # 391
A client who is a breast-feeding mother develops mastitis. The clinical signs and symptoms of mastitis include:

• A. Marked engorgement, elevated temperature, chills, and breast pain with an area that is red and hardened
• B. Cracked nipple with complaints of soreness
• C. Marked engorgement and breast pain
• D. Elevated temperature and general malaise

Answer: A

Explanation:
Explanation
(A) Mastitis is a bacterial inflammation of the breast tissue found primarily in breast-feeding mothers. The bacteria usually enter the breast through a cracked nipple, or the infection results from stasis of milk behind a blocked duct. (B) With breast engorgement during breast-feeding, there may be marked breast pain. This is not necessarily a sign of infection. (C) Women may become ill during breast-feeding with other bacterial or viral infections that are not related to mastitis. (D) Improper care of the nipples or improper positioning of the infant during breastfeeding may result in cracked or sore nipples.

NEW QUESTION # 392
A client returns for her 6-month prenatal checkup and has gained 10 lb in 2 months. The results of her physical examination are normal. How does the nurse interpret the effectiveness of the instruction about diet and weight control?

• A. She needs to be placed on a restrictive diet immediately.
• B. She needs to increase her caloric intake.
• C. She is compliant with her diet as previously taught.
• D. She needs further instruction and reinforcement.

Answer: D

Explanation:
Section: Questions Set A
Explanation:
(A) She is probably not compliant with her diet and exercise program. Recommended weight gain during second and third trimesters is approximately 12 lb. (B) Because of her excessive weight gain of 10 lb in 2 months, she needs re-evaluation of her eating habits and reinforcement of proper dietary habits for pregnancy.
A 2200-calorie diet is recommended for most pregnant women with a weight gain of 27-30 lb over the 9-month period. With rapid and excessive weight gain, PIH should also be suspected. (C) She does not need to increase her caloric intake, but she does need to re-evaluate dietary habits. Ten pounds in 2 months is excessive weight gain during pregnancy, and health teaching is warranted. (D) Restrictive dieting is not recommended during pregnancy.

NEW QUESTION # 393
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